Independent Physical Therapy of Ga, LLC
Organization Active NPI Physical Therapist · Canton, GA
NPI 1174927784 · NPPES record last updated Oct 11, 2014
Key facts
- NPI
- 1174927784
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 225100000X
- Legal business name
- INDEPENDENT PHYSICAL THERAPY OF GA, LLC
- Practice address
- 6768 Hickory Flat Hwy
Ste 110
Canton, GA 30115-9376 - Phone
- (770) 721-5767
- Fax
- (770) 345-0158
- NPI assigned
- Oct 11, 2014
- Organization subpart
- No
Authorized official
- Name
- Kevin Johanneson
- Title
- VP Revenue Cycle
- Phone
- (423) 238-7217
Corporate family (same tax ID) 24
National Provider Directory
- Tax ID family
- Independent Physical TH
Locations
6768 Hickory Flat Hwy
Ste 110
Canton, GA 30115
Phone (770) 704-8244
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | Yes | ||
| Occupational Therapist |
225X00000X |
Addresses
Primary practice location
6768 Hickory Flat Hwy
Ste 110
Canton, GA 30115-9376
Mailing address
8823 Production LN
Ooltewah, TN 37363-6511
Phone (423) 238-8923
Other names
- BENCHMARK PT- HOLLY SPRINGS
Other providers in Canton, GA
- Imaging Associates of Canton
- Improved Insight Counseling Services Incorporated
- In Your Element Therapy
- Inclusive Rehabilitation LLC
- Independent Physical Therapy of Ga LLC
- Independent Physical Therapy of Ga, LLC
- Independent Physical Therapy of Georgia, LLC
- Katherine Renee Ingle
- Guwoin Ingram Jr Jr.
- Martin Breland Inman
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 11, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.